摘要
目的探讨肺泡灌洗液宏基因组二代测序在肾移植后肺部感染病原体鉴别中的应用价值,为临床检测提供参考。方法选取2019年10月-2023年10月在郑州市第七人民医院治疗的肾移植后肺部感染患者62例,所有患者给予肺泡灌洗液传统病原体检测和基因检测,对比分析基因检测和传统检测的效果差异。结果基因检测检测时间为(3.10±0.92)d,明显快于传统检测(7.02±1.03)d,差异有统计学意义(t=-22.350,P<0.05);基因检测病原体检出率为93.55%(58/62),明显高于传统检测35.48%(22/62),差异有统计学意义(χ^(2)=45.655,P<0.05)。62例患者基因检测中,单一感染50例,混合感染8例,有4例患者未检出病原体,单一感染以耶氏肺孢子菌、新冠病毒、巨细胞病毒和曲霉菌为主;传统检测中,单一感染21例,混合感染1例,有40例患者未检出病原体,单一感染以耶氏肺孢子菌、新冠病毒为主。基因检测单一感染、混合感染检出率分别为80.65%(50/62)和12.90%(8/62),明显高于传统检测33.87%(21/62)和1.61%(1/62),差异均有统计学意义(χ^(2)=27.713、4.313,P均<0.05);不同性别、年龄、原发疾病及感染发生距移植术时间患者基因检测病原体检出率比较差异均无统计学意义(P均>0.05)。结论肺泡灌洗液基因检测在肾移植后肺部感染病原体鉴别中有较好的应用价值,能提高病原菌检出率,缩短检测时间。
Objective To explore the application value of metagenomics nextgeneration sequencing in alveolar lavage fluid in identifying pathogens of pulmonary infections after kidney transplantation.Methods A total of 62 patients with lung infections after kidney transplantation who were treated in the Zhengzhou Seventh People's Hospital from October 2019 to October 2023 were selected.All patients were subjected to traditional pathogen testing and genetic testing in bronchoalveolar lavage fluid,and the differences between genetic and traditional testing were analyzed.Results The genetic testing time was(3.10±0.92)d,which was significantly faster than traditional testing time(7.02±1.03)d(t=-22.350,P<0.05).The detection rate of pathogens in genetic testing was 93.55%(58/62),which was significantly higher than that of traditional testing 35.48%(22/62)(χ^(2)=45.655,P<0.05):Among the 62 patients who underwent genetic testing,there were 50 cases of single infection and 8 cases of mixed infection.Among them,4 patients did not detect pathogens,and single infections were mainly caused by Pneumocystis jiroveci,COVID-19,cytomegalovirus and Aspergillu.In traditional testing,there were 21 cases of single infection and 1 case of mixed infection.40 patients were not detected for pathogens,and single infections were mainly caused by Pneumocystis jiroveci and COVID-19.The detection rate of single infection and mixed infection in genetic testing was 80.65%(50/62)and 12.90%(8/62),respectively,which was significantly higher than those in traditional testing 33.87%(21/62)and 1.61%(1/62)(χ^(2)=27.713,4.313;all P<0.05).There was no statistically significant difference(P>0.05)in the detection rate of pathogens in genetic testing among patients of different genders,ages,primary diseases,and time between infection occurrence and transplantation surgery.Conclusion The genetic testing of alveolar lavage fluid had good application value in identifying pathogens of pulmonary infections after kidney transplantation,which could improve pathogen detection and shorten detection time.
作者
杨青彦
刘君毅
殷正伟
杨俊伟
索敬钧
王长安
王晓勃
李涛
YANG Qingyan;LIU Junyi;YIN Zhengwei;YANG Junwei;SUO Jingjun;WANG Changan;WANG Xiaobo;LI Tao(Renal Transplantation Kidney Disease Diagnosis and Treatment Center,Zhengzhou Seventh People's Hospital,Zhengzhou,Henan 450016,China)
出处
《热带医学杂志》
2025年第4期511-514,共4页
Journal of Tropical Medicine
基金
河南省医学科技攻关计划联合共建项目(LHGJ20210757)。
关键词
肺泡灌洗液
基因检测
肾移植
肺部感染
病原体
Alveolar lavage fluid
Genetic testing
Kidney transplantation
Pulmonary infection
Pathogen
作者简介
杨青彦(1980-),男,副主任医师,主要从事肾移植围手术期管理,E-mail:yangyqy10@163.com。
